There are over 600 Adult Care Homes in Multnomah County, and over 350 of them primarily serve older adults age 65 and with moderate care needs.
Multnomah County also has over 200 adult care homes serving adult with developmental disabilities. It is not unusual for vacancies in these DD-licensed homes to have multiple vacancies. This means that many operators are competing for the same residents. In planning your small business, you want to do marketing research and planning so that you can compete in this market.
Location, location, location
Where are the most homes?
Most Adult Care Homes in Multnomah County serving older adults and adults with disabilities are between 122nd and 162nd Avenues, both Northeast and Southeast.
Many of these homes have been custom built as adult care homes. They have spacious bedrooms and living areas, private half baths, roll-in showers, custom built ramps and open kitchens, which allow providers to watch residents. Other homes have been adapted for wheelchairs and other needs.
There also many homes east of 162nd Avenue out to and including Gresham. Again, there are many custom-built Adult Care Homes in this area.
If the house you are considering for your Adult Care Home is in either of these areas, you will need to be competitive. Consider meeting a need that others are not meeting.
All other areas in Multnomah County have fewer Adult Care Homes.
Multnomah County needs more homes in these areas:
- Northwest Portland
- Southwest Portland
- North Portland
- Northeast Portland
- Southeast Portland out to 122nd Avenue
North/Northeast Portland: Homes needed
Many long time residents of North and Northeast Portland would like to remain in the area where they have lived for so many years close to family, their church or other community gathering place, friends, parks, and familiar businesses.
The housing stock in North and Northeast does not lend itself to being easily adapted to accommodate five residents on the ground level. But if you can find a property that can be adapted for use as an Adult Care Home, there is a need, and you may be more likely to attract residents than if you were to open your business in an area which already has many Adult Care Homes.
Research tool for deciding location
We encourage you to use our Adult Care Options website as a research tool for discovering whether or not a zip code area or geographical area you are considering for your business may have ample homes with vacancies.
The site allows you to search for homes by area or zip code. Try conducting a search for “all homes” in a zip code area you are considering for your business. Look carefully at the results.
- Are there a lot of homes?
- How many have listed vacancies? Keep in mind that some homes may have unlisted vacancies.
- What do the homes look like?
- Can you afford a home as nice as the homes pictured?
- Can you offer the amenities and care that the homes listed are offering?
- Can you really measure up to the competition? Be honest with yourself.
- What can you offer that others don't?
Examine your strengths as a caregiver and make them a marketing asset
Take an inventory of your caregiving experience and other skills.
- Who have you assisted and what care needs have you most enjoyed meeting?
- Do you have special skills or training? Perhaps you are an RN or a respiratory therapist?
- Are you fluent in a language other than English?
- Are you familiar with the cultural needs of a particular population?
By meeting special needs in your home, you may find that you can attract people you are best suited to assist.
Here is a list of special skills which may be needed by older adults and disabled adults in Multnomah County and which can help you attract residents to live in an Adult Care Home.
Care needs
- Hospice and palliative care
- RN operated home for wound care, sliding scale diabetes, complex medical tasks
- HIV/AIDS
- Morbidly obese/bariatric care
- Mental Health and behavioral support
- Dementia home for wanderers with an enclosed back yard of “track” for walking
- Traumatic Brain Injury
- Neurological diseases – Multiple Sclerosis, Huntington’s Disease, ALS (Amyotrophic lateral sclerosis) etc
- Medical marijuana
Cultural needs
- Chinese language and culture
- Russian language and culture
- Korean language and culture
- African American culture
- Native Spanish speakers – variety of Latino/Hispanic cultures
- LGBT welcoming (lesbian, gay, bi-sexual, transgender)
- Younger people with disabilities – age 64 and younger
How do I get residents for my home?
It is the operator’s responsibility to market their own home and/or to inform programs that help place residents that they have a vacancy.
Homes serving older adults and adults with disabilities may promote free of charge on the county's Adult Care Options website(link is external).
Can I buy someone else’s licensed home, and take over the business?
No. A new license is required independent from that of the currently licensed operator.
Before an operator closes their home, all residents are given 30 days notice to move. However, if the residents choose to stay and be cared for by the new operator, they may if that new operator can meet the care needs and license requirements.
Does Multnomah County have the same rules for Adult Care Homes as the rest of the state?
No. Multnomah County has exempt status, which means:
- different administrative rules than rest of state
- different licensing requirements than rest of state
Multnomah County licenses homes for People with Intellectual/Developmental Disabilities, Seniors and People with Disabilities, and Mental Health and Addictions. The rest of the state has different work units for licensing.
What is a Room and Board home?
A room and board home provides a private or shared room, meals and snacks, medication management, laundry service, but no hands-on care to older adults or adults with disabilities.
The maximum capacity of the home is not limited to five people, but is determined by the physical characteristics of the home and fire safety requirements.
Medicaid does not pay for room and board homes.
Learn more: Room and Board License Application Process
What do I need to know to start a business?
If you are thinking of applying for a license to run an adult care home, you will also want to research what it takes to start a business and to be an employer. Making a business plan before starting the licensing application process will help you be a successful business owner and employer. The Oregon Secretary of State's office has two great resources to help you get started:
Learn more about how to become an adult care home operator.